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Safety in paediatrics requires a focus on providing highly reliable, effective care and reducing avoidable harm both in lower-income countries, where the emphasis is on neonatal care, and in higher-income countries, where hospital care is increasingly complex as a result of preventable harm. Safety is a challenge because of four main differences in children that are related to development, dependence, differential epidemiology, and demographics. Most of the preventable harm is related to medication, deterioration, sepsis, hospital-acquired infections, and psychological well-being. Early warning systems, care bundles, and other frontline tools and initiatives can reduce harm and improve situation awareness. A multidisciplinary approach to safety, based on human factors principles and inspired by a culture of patient and parent engagement, is crucial. The paediatric trigger tool is a useful way to measure harm and identify areas for improvement. Multisite collaborative improvement networks are a good starting point for improving the safety of paediatric patients. |
